Psikhiatriia nevrologiia ta medichna psikhologiia最新文献

{"title":"Clinical-psychopathological structure of hallucinator-paranoid disorders during vascular dementia of heavy direction of expression","authors":"","doi":"10.26565/2312-5675-2019-12-03","DOIUrl":"https://doi.org/10.26565/2312-5675-2019-12-03","url":null,"abstract":"The purpose of this study is to determine the clinical and psychopathological features of hallucinatory-paranoid disorders in severe vascular dementia. The clinical and psychopathological structure of hallucinatory and paranoid disorders in patients with severe vascular dementia was studied in a group of 34 patients with mixed cortical-subcortical dysfunction with hallucinatory-paranoid symptoms — F01.3 (1-2), which consisted the main group. As a control group, the study involved 29 patients with severe vascular dementia (F01.3), without by hallucinatory-paranoid disorders. To achieve the goal and objectives of the study, a set of research methods was used, including the clinical and psychopathological method, supplemented by the Behavioral Disorders Scale (Bahav-AD), neuropsychiatric questionnaire (NPI), non-cognitive sections of the AD assessment scale (ADAS-Non Cog) and methods of statistical data processing. According to the results of the study, the following symptoms were revealed in the structure of hallucinatory-paranoid disorders in patients with severe vascular dementia: the prevalence of hallucinatory disorders over paranoid and paranoid disorders; the dominance in disorders of perception of frequent visual, auditory and tactile hallucinations of moderate severity; the prevalence of delusional beliefs that “the house is not his house” and the spouse/caretaker is impostors; the predominance of non-deployed, unsystematized and sketchy crazy ideas, that do not tend to expand; a combination of hallucinatory and paranoid disorders with frequent aimless activity of moderately strong severity; frequent generalized anxiety of moderate to severe severity; frequent sleep/wake rhythm disturbances of moderate severity; periodic moderate swagger; pronounced distractibility. The data obtained should be taken into account when conducting differential diagnosis of patients with hallucinatory-paranoid disorders in severe vascular dementia.","PeriodicalId":33688,"journal":{"name":"Psikhiatriia nevrologiia ta medichna psikhologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69006508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical-neuropsychological features of the hepatic encephalopathy formation","authors":"Удк, Печінкової Енцефалопатії","doi":"10.26565/2312-5675-2019-11-07","DOIUrl":"https://doi.org/10.26565/2312-5675-2019-11-07","url":null,"abstract":"35 patients with different stages of the hepatic encephalopathy on the background of the chronic hepatitis at the age of 45.2 ± 5.8 years were examined. The investigation complex included neurological, psychometric (numbers connection test, SDMT number-symbol test, Schulte tables, Montreal cognitive function evaluation scale, HADS scale), and instrumental (EEG and MRI of the brain) examination. The findings showed that early clinical manifestation of hepatic encephalopathy included mild cognitive impairments, sleep disturbances (initial manifestations of impaired consciousness), emotional disorders (asthenic syndrome, anxiety) and impaired fine motor movements (changes of handwriting and fine coordination). According of the psychometric testing results the signs of the hepatic encephalopathy latent stage were detected including an impairment of the attention (due to numbers connection test results), a decrease of the cognitive processes speed and a violation of visual short-term memory (SDMT), difficulty in delayed reproduction of the information, a violation of fine motor movements (change handwriting). Disturbance of the brain bioelectrical activity was characterized by slowing the frequency of the alpha rhythm, an increase in the slow-wave activity index, smoothed zonal differences, and recording of hypersynchronous alpha waves or three-phase waves, which were determined already in the early stages of the disease. Comparing the psychometric testing data and the neuroimaging results, it was noted that the identified cognitive disorders, including those at the latent stage of hepatic encephalopathy, were accompanied by the frontal and parietal lobes cortex hypotrophy and the subcortical structures damage. Progression of the hepatic encephalopathy was accompanied by increased cognitive, emotional, motor and sleep disorders, which was confirmed by the results of psychometric testing, and also coincided with the functional and morphological disorders worsening of the brain according to the neurophysiological and neuroimaging examinations.","PeriodicalId":33688,"journal":{"name":"Psikhiatriia nevrologiia ta medichna psikhologiia","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69005894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction of auto-aggressive trends as a link to the psychoneurological model of adaptation of patients with demyelinizing pathology","authors":"","doi":"10.26565/2312-5675-2019-11-08","DOIUrl":"https://doi.org/10.26565/2312-5675-2019-11-08","url":null,"abstract":"In this article, we analyzed current data on autoaggression in patients with demyelinating pathology. We noted that the issues of neuropsychiatric adaptation and rehabilitation of patients with demyelinating pathology remain acutely relevant to date. An important place in the package of measures for the early detection of disorders in the emotional sphere is occupied by studies of aggression, in particular, unconscious aggression, which under certain conditions can acquire an autoaggressive orientation. It has been established that there is no information on the severity of unconscious aggression in patients with multiple sclerosis of the Ukrainian population, which are important for identifying targets for the prevention of suicidal activity. The article presents the results of the “Hand-test” method for residents of the Eastern region of Ukraine with a remitting type of multiple sclerosis (RT MS) who were treated at the Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine (n = 71). The study was carried out in connection with the task of improving the neuropsychiatric model of adaptation and rehabilitation of patients based on the early identification of autoagression prevention targets. The tendency to aggressive behavior was assessed by comparing the trends reflecting the readiness for aggressive behavior, as well as the trends that suggest cooperation. We have identified difficulties in the field of social contacts, which can find expression in being fenced off from others and formalism in relationships. We have identified such a psychodiagnostic profile in which, against the background of increased unconscious aggression, indicators of dependence and personality immaturity dominate. This combination carries a potential threat to the realization of an auto-aggressive trend. The study, which was conducted, revealed a general increased tendency to manifest aggressiveness in the examined patients. Patients intensely felt a sense of dependence, helplessness, subordination, and at the same time did not realize their aggression; this was identified by us as a target of prevention of potential suicidal activity. The study, identification and further correction of unconscious behavioral trends is an important part of the neuropsychiatric model of adaptation of patients with demyelinating pathology.","PeriodicalId":33688,"journal":{"name":"Psikhiatriia nevrologiia ta medichna psikhologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69005911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-stroke pain","authors":"W. Yu-jie","doi":"10.26565/2312-5675-2019-11-06","DOIUrl":"https://doi.org/10.26565/2312-5675-2019-11-06","url":null,"abstract":"The purpose of the study was to assess the prevalence of post-stroke pain and the effectiveness of its diagnosis and treatment in the conditions of university clinic. It was shown that the frequency of post-stroke pain syndrome is 55.8% of the total number of patients with PPS. The pain in the shoulder joint of the paretic limb is most often recorded, due to the subluxation of the humerus, which is recorded in 28.3% of patients with PPS during hospital stay and 20.3% in the first weeks after discharge. The frequency of PPS of the central genesis is 31.1%. Syndrome of complex regional pain occurs in 4.4% of patients, pain associated with spasticity – in 13.0%. The use of visual analog scales makes it possible to diagnose post-stroke pain syndrome in patients who are conscious and have no significant cognitive deficits. With the application of complex treatment of pain syndrome, a satisfactory clinical effect is achieved in all patients, and the best response to treatment was in patients with pain in the shoulder joint of the paretic limb due to the subluxation of the head of the humerus.","PeriodicalId":33688,"journal":{"name":"Psikhiatriia nevrologiia ta medichna psikhologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69005880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychotherapy and psychological consulting in rehabilitation programs of psychoactive substances abused","authors":"","doi":"10.26565/2312-5675-2019-11-09","DOIUrl":"https://doi.org/10.26565/2312-5675-2019-11-09","url":null,"abstract":"Psychotherapy and psychological counseling in narcology are an important component of the therapeutic and prophylactic process and are used in the complex of rehabilitation measures. Is inseparable from medication, physiotherapy and psychosocial effects, begins at the earliest stages of treatment. The use of psychotherapy in the rehabilitation phase of chemically dependent persons is necessary and promising. Effective psychotherapeutic programs involve the use of a whole range of psychotherapeutic approaches that include various methods and forms of psychotherapy that are used by the community of specialists in unison with the complex of psychopharmacotherapy and other non-drug therapies. Each separate strategic stage of rehabilitation of substance addicts corresponds to a specific psychotherapeutic method. Psychotherapeutic rehabilitation measures in narcology should be personality-oriented, differentiated and comprehensive, including both psychotherapeutic rehabilitation measures and drug-centered rehabilitation approaches. In stages, the introduction of elements of the psychotherapy-rehabilitation approach, which is necessary from the very beginning, at the stage of acute conditions. If successful psychotherapy optimizes the totality of personal statuses seeking their harmonious disclosure and fixing the position of the individual in the desired statuses. The basic principles of psychotherapy abusing on surfactants are considered in unison with the modern concepts of treatment in general and include volunteering, individuality, complexity and refusal to use psychoactive substance.","PeriodicalId":33688,"journal":{"name":"Psikhiatriia nevrologiia ta medichna psikhologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69006454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The occurrence of acute demyelinating encephalomyelitis after respiratory viral infection (clinical observation)","authors":"","doi":"10.26565/2312-5675-2019-12-06","DOIUrl":"https://doi.org/10.26565/2312-5675-2019-12-06","url":null,"abstract":"This article examines the development of acute demyelinating encephalomyelitis against a background of a viral infection in a clinical case. Based on the literature review, it is known that acute disseminated encephalomyelitis is an immuno-mediated single-phase inflammatory demyelinating disorder of white matter of the brain and spinal cord. It is noted that one of the proposed mechanisms of pathogenesis is that myelin autoantigens, such as myelin main protein, proteolipid protein and myelin oligodendrocyte protein, have antigenic determinants with the infecting agent. Antiviral antibodies or cell-mediated cross-reacting pathogens respond to myelin autoantigens, resulting in acute demyelinating encephalomyelitis. Acute demyelinating encephalomyelitis has been found to be associated with increased vascular permeability and accumulation of circulating immune complexes or other humoral factors that develop after exposure to a foreign antigen introduced by infection or vaccination. This process then leads to infiltration of the walls of the vessels by mononuclear cells with subsequent swelling and periodic hemorrhage. Microglia, lymphocytes, and phagocytes appear throughout the day, ultimately leading to demyelination and possible gliosis and necrosis. The degree of demyelination and subsequent glial and neural changes explain the difference between clinical features and disease prognosis. In clinical case, we have demonstrated the appearance of this disease, which developed in close temporal connection with infectious disease. Positive meningeal signs, tenderness and limited movements of the eyeballs, diplopia when viewed sideways, decreased convergence, horizontal nystagmus when viewed sideways, symptoms of oral automatism, decreased muscle strength diffuse, tendons and tendons = D, average liveliness; from the feet S> = D, average liveliness, tremor of the hands. The MRI findings, in addition to the clinical picture, helped to establish the diagnosis. As a result of this, a cure for the disappearance of a neurological deficit was achieved. Thus, this clinical case proves that disseminated encephalomyelitis proceeds by type of acute disease with rapid increase of symptoms and their subsequent regression.","PeriodicalId":33688,"journal":{"name":"Psikhiatriia nevrologiia ta medichna psikhologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69006550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex post-traumatic stress disorder in participants of the military actions in the operation militarygroups in the view of the eleven edition of the International classification of diseases","authors":"","doi":"10.26565/2312-5675-2019-11-02","DOIUrl":"https://doi.org/10.26565/2312-5675-2019-11-02","url":null,"abstract":"The introduction of the new concept of complex post-traumatic stress disorder (cPTSD) in the International Classification of Diseases of the 11th Edition deserves attention in a country where active fighting is taking place. The increase in the number of PTSD sufferers among military personnel and civilians on the territory of hostilities increases the likelihood of PTSD occurring among the contingent. At present, we have no experience in the diagnosis of cPTSD. The objective of our study, along with the diagnosis of PTSD symptoms, is to use a quality of life questionnaire to evaluate the symptoms of cPTSD. The result revealed that the level of community and service support was below average, indicating the need to improve community social support. The self-realization of the combatants has a low average level, which further influences the level of adaptation after the end of the service. Physical and psychological well-being are also low, and this indicator to the need for psychological and physical rehabilitation of demobilized soldiers. At the same time, communication with friends and family, performance were at a high enough level, and these are positive factors that influence the adaptation to civilian life. Summarizing the research, we suggest that in order to organize the help of the combatants more effectively, it is necessary to evaluate, along with a purely psychiatric diagnosis of PTSD, the level of social and physical adaptation of patients with PTSD.","PeriodicalId":33688,"journal":{"name":"Psikhiatriia nevrologiia ta medichna psikhologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69005772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychoemotional reactions at the stage of clinically isolated multiple sclerosis syndrome","authors":"","doi":"10.26565/2312-5675-2019-12-08","DOIUrl":"https://doi.org/10.26565/2312-5675-2019-12-08","url":null,"abstract":"A prospective study of functional disability and its relationship to the emotional response of a patient to the diagnosis of 30 patients with clinically isolated syndrome (CIS) of Multiple Sclerosis (MS) was performed. The aim of the study was to evaluate the typical emotional reactions in patients with CIS MS and to determine their impact on patients' functional failure in the future. The study was conducted in three stages. In the first stage, before the infusion of methylprednisolone, an emotional response and a degree of functional failure were assessed. Evaluation of the reliability of emotional emotional reaction was performed after 7 days. Re-evaluation of psycho-emotional response and functional disability was performed during recurent MS attack. A total of 30 patients were included in the study, with an average age of 32.07 ± 8.54 years, including 27 women and 3 men. The most frequent emotional reactions were found to be anxiety (60%), shock reaction (16.56%) of patients, categorical denial of diagnosis (13.33%). Relief was less frequent — 6.67% and sorrow in 3.33% of patients. The reliability of the emotional response was re-evaluated after 7 days (Cronbach's α 0.993). The time interval from the moment of CIS MS to the second attack and diagnosis of MS was 6.33 ± 3.467 months. The EDSS score at the time of the second attack was 2.92 ± 0.081 points. A one-way ANOVA procedure was also used for the multivariable analysis to establish the statistical difference of the EDSS score for different levels of the Reaction score. A statistically significant correlation was established between the response values and the Expanded Disability Status Test (EDSS) total score at P <0.01, as well as the EDSS score at the second clinical attack. It was found that the emotional background of the patient influences the prognosis and functional failure in the dynamics.","PeriodicalId":33688,"journal":{"name":"Psikhiatriia nevrologiia ta medichna psikhologiia","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69006569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive functions in a mixed episode of bipolar affective disorder","authors":"","doi":"10.26565/2312-5675-2019-12-01","DOIUrl":"https://doi.org/10.26565/2312-5675-2019-12-01","url":null,"abstract":"Summary. According to various meta-analyzes, most patients with bipolar affective disorder have neurocognitive dysfunction even in remission. In recent studies, moderate to severe impairments have been found in attention, verbal learning and memory, and executive function. Whereas premorbid intelligence remains unchanged. The main body of research is devoted to the study of cognitive impairment in the first episode of bipolar affective disorder, in manic, depressive episodes, and euthymia. At the same time, the features of cognitive dysfunction in mixed forms of bipolar affective disorder remain poorly understood. The aim of the study was to study the characteristics of cognitive functions in patients with a mixed episode of bipolar affective disorder. Materials and methods. With the help of a battery of tests (a test for remembering ten unrelated words; a Ray-Osterritz test; a verbal speed test; a digital character substitution test; a symbol linking test), the cognitive features of 25 patients with a mixed episode, 16 patients with a manic episode, and 15 patients with a depressive episode of bipolar affective disorder. Results and conclusions. Deviations in cognitive function were found in all patients regardless of the type of affective symptomatology. In the form of a wide range of psychopathological phenomena which manifested themselves to a greater extent in patients with a mixed episode of bipolar affective disorder. The peculiarities of the phenomenological structure of cognitive impairment in patients with mixed phase of bipolar affective disorder are manifested in the form of a more pronounced deterioration of verbal memory, information processing speed; more pronounced violations of spatial representations, deterioration of visual memory, verbal associative performance and executive functions; a decrease in attention and a violation of its distribution. The findings suggest that the leading role in the formation of these disorders is played by the presence of depressive symptoms in the clinical structure of affective disorders.","PeriodicalId":33688,"journal":{"name":"Psikhiatriia nevrologiia ta medichna psikhologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69006496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"History of medicine as part of medical science, the role, importance, development and support of its scientific direction in healthcare","authors":"","doi":"10.26565/2312-5675-2019-12-10","DOIUrl":"https://doi.org/10.26565/2312-5675-2019-12-10","url":null,"abstract":"The article is devoted to the history of medicine as part of medical science, its role, the importance of developing and supporting its scientific direction in healthcare, the second Congress of medical historians of Ukraine with international participation on the occasion of the 215th anniversary of the Medical faculty of Vasyl Nazarovych Karazin Kharkiv National University. The event that took place on this occasion at the V.N.Karazin Kharkiv National University on October 22 and 23, 2019 in the Column Hall of the Northern Corps, which brought together scientists from all over Ukraine and other countries, is reflected in detail. It is said that the Ukrainian Academy of History of Medicine (UAHM) was the main initiator of the Second Congress, and Professor A.A. Oparina was elected the President. Holding of the II Congress of medical historians of Ukraine with international participation was undeniable evidence of decisive action by the Ukrainian Academy of the History of Medicine. The attention was paid to the fact that the Congress of medical historians of Ukraine was promoted by: V.N. Karazin Kharkiv National University, Kharkiv Medical Academy of Postgraduate Education, Kharkiv National Medical University, Kharkiv Medical Society, Ukrainian Academy of Social Sciences, Professor V.D. Ottoman Center for Local History, Honored Professor N.S. Bocarius Kharkiv Research Institute of Forensics, and others. The program of the Congress consisted of two plenary sessions, attended by 78 scientists and teachers from three foreign higher educational institutions and eight educational and scientific institutions of Kharkiv and other cities of Ukraine and more than 250 Doctors and Masters, graduate students and students of medical, philosophical and historical faculties, three Kharkiv higher educational institutions and numerous medical institutions. The article discusses numerous fascinating reports on the development of medical science both in Ukraine and abroad. The program of the Congress is described. It includes 28 reports, in which the scientific aspects and directions of research on the history of Ukrainian and world medicine, their theoretical, scientific, academic and practical significance, discussions and adoption of a resolution were examined.","PeriodicalId":33688,"journal":{"name":"Psikhiatriia nevrologiia ta medichna psikhologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69006620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}